TAG:
revenue cycle management
Managing Denials and Appeals of Clinical Lab, Path Claims
CEO SUMMARY: Based on a study of denials and appeals involving about 20 million lab test claims, the team at XiFin Inc. presents here their findings. They also provide recommendations on steps labs can take to reduce denials and win a greater proportion of appeals. IN RECENT…
Artificial Intelligence ‘Invades’ Pathology, Billing
Predictions about the potential of artificial intelligence (AI) to transform nearly every area of healthcare are about to become reality. For the profession of laboratory medicine, AI is making speedy inroads into two areas. The first is anato…
Latest Lab Billing Trends Are AI, More Transparency
CEO SUMMARY: From predictive analytics to data curation to improved online payment options, the newest trends in billing allow clinical laboratories and anatomic pathology groups to boost their financial bottom lines without putting more pressure on patients. Technology is at the co…
XIFIN’s Acquisition of OmniSYS Will Unite Lab with Pharmacy
This is an excerpt of a 1,829-word article in the January 10, 2022 issue of THE DARK REPORT (TDR). The full article is available to members of The Dark Intelligence Group. CEO SUMMARY: XIFIN’s acquisition of OmniSys, a pharmacy technology company, is the latest evidence that …
XIFIN Buys OmniSYS, Bridges Lab to Pharmacy
CEO SUMMARY: XIFIN’s acquisition of pharmacy technology company OmniSYS is the latest evidence that retail pharmacies are preparing to become a new front door to healthcare for consumers. The deal allows XIFIN to bring clinical lab information about patients directly to pharmacist…
Insurers Get Aggressive with Years-Old Audits, Searching for Lab Overpayments
This is an excerpt of a 1,971-word article in the July 26, 2021 issue of THE DARK REPORT (TDR). The full article is available to members of The Dark Intelligence Group. CEO SUMMARY: Not only are health insurers looking back to find lab overpayments and funds paid erroneously, but…
Insurers Get Aggressive with Years-Old Audits
CEO SUMMARY: Not only are health insurers looking back to find overpayments and funds paid erroneously, but payers also are requiring documentation for overpayments. If clinical labs and anatomic pathology groups do not appeal such claims quickly, they may be liable for any amount i…
XIFIN to Open New Office in South Carolina for Lab Billing
SINCE FEBRUARY, THE TOTAL NUMBER OF PEOPLE VACCINATED grew steadily even as the number of tests for COVID-19 declined sharply in the United States. But overall test volume has remained steady at 130% of pre-pandemic levels, said Brian Kemp, Vice President of Revenue Cycle Operations for XIFIN,…
Benefits Investigation Is Growing Issue for Genetic Testing Labs
QUIETLY AND WITH LITTLE NEWS COVERAGE, a new complication is challenging clinical laboratories that offer genetic testing. It involves a steady growth in the number of patients who do a “benefits investigation” before allowing their physician to order a genetic test….
ICD-10 Gives Payers More Data About Lab Claims
CEO SUMMARY: Evidence shows that adoption of ICD-10 diagnosis codes in 2015 made it possible for health insurers to track clinical laboratory testing more closely, ask more questions about those tests, and deny coverage. Increased detail about each patient’s condition has led to increas…
CURRENT ISSUE
Volume XXXII, No. 1 – January 6, 2025
The Dark Report examines how AI is being used to predict the outcomes of FDA LDT lawsuits. Also, this issue is Part Two of a series about boosting pathology compensation in different settings, including hospitals. Two experienced pathology consultants identify the most effective approaches when negotiating Part A pathology agreements with hospitals and health systems, along with how to use data to bolster these negotiations.
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